Provider Demographics
NPI:1063616167
Name:MINNICK, DAVID BRANDON (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRANDON
Last Name:MINNICK
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Gender:M
Credentials:DO
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Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M-283
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-349-7696
Mailing Address - Fax:269-488-8313
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M-283
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-349-7696
Practice Address - Fax:269-488-8313
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
MI5101016805208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery